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PREVALENCE'OF'MANDIBULAR'
ASYMMETRY'IN'SKELETAL'CLASS'I'
ADULT'PATIENTS'
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ABSTRACT'
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AIM:' The' objective' of' this' study' was' evaluating' the' prevalence' of'
mandibular' asymmetry' in' skeletal' Class' I' adult' patients.'
MATERIALS' AND' METHODS:'The'sample'was'composed'by'coneE
beam'computed'tomography'images'of'250'skeletal'Class'I'patients'
with'age'from'18'to'70'years'old.'The'side'deviation'of'mandibular'
asymmetry'was'evaluated'(right'and'left),'as'well'as'the'intensity'of'
this' asymmetry.' People' with' gnathic' deviation' until' 2mm' were'
considered'as'patients'with'slight'asymmetry;'deviation'between'2'
and' 5mm' was' considered' moderate' asymmetry' and' those' higher'
than' 5mm' as' severe' asymmetries.' The' error' calculation' method'
was' performed' and' there' was' not' significant' error' in' the'
measurements.'To'verify'the'association'between'the'prevalence'of'
mandibular' asymmetry' and' the' gender' of' individuals,' the' 2' was'
carried' out' and' the' significant' level' adopted' was' 5%' (p<0.05).'
RESULTS:'The'results'showed'that'mandibular'deviation'occurred'
more' frequently' to' the' left' side' in' both' genders' (male' 56.5%' e'
female' 58.2%),' without' statistically' significant' difference' between'
them' (p=0.792).' Besides,' the' prevalence' of' slight,' moderate' and'
severe' asymmetries' were,' respectively' 61%,' 27%' and' 12%' for'
males' and' 54%,' 28%' and' 18%' for' female;' and' there' was' not'
statistically'significant'difference'(p=0.366)'between'the'gender'of'
the' sample' evaluated.' CONCLUSION:' In' this' study,' both' deviation'
and'intensity'of'mandibular'asymmetry'did'not'present'preference'
regarding'to'the'gender.'
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GRIBEL,'Bruno'Frazo*'
THIESEN,'Guilherme**'
BORGES,'Tssia'Silvana***'
FREITAS,'Maria'Perptua'Mota****'
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KEYWORDS'
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Facial'Asymmetry.'Orthodontics.'Orthognathic'Surgery.''
ConeEBeam'Computed'Tomography.'
Master'in'Orthodontics'by'Pontifical'Catholic'University'of'Minas'Gerais,'Minas'Gerais,'Brazil*'
Student'of'Doctor'Degree'in'Orthodontic'(emphasis'in'Orthodontics)'at'Lutheran'University'of'Brazil,'Brazil**'
Student'of'Master'Degree'in'Orthodontics'(emphasis'on'Pediatric'Dentistry)'at'Lutheran'University'of'Brazil,'Brazil***'
Professor'of'the'Graduation'and'PostEGraduation'Program'in'Orthodontics'at'Lutheran'University'of'Brazil,'Brazil****'
Correspondence:'guilhermethiesen@yahoo.com.br'(THIESEN'G)'|'Received'10'Feb'2014'Received'in'revised'form'15'Feb'2014'Accepted'24'Feb'2014'
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190
INTRODUCTION
characteristic&in&this&asymmetry5.
&
craniofacial&symmetry&in&front&view1,2.
&
the&nature,&and&thus,& the&expectation&about&the&
during&a&closer&observation.&It&is&due&to&the&fact&
has&development&from&the&medial&nasal,&lateral&
becomes&perceptible4.
&
5mm3,4,6,7,8&.&Under&this&value,&the&asymmetry&is&
growth3,4&.
human&sensitivity&to&realize&severe&unbalances&
&
JRD&X&Journal&of&Research&in&Dentistry,&Tubaro,&v.&2,&n.&2,&mar/apr.&2014
191
thickness&of&the&soft&tissue&over&the&unbalanced&
these&tests,& all&the&patients&in&this&sample&used&
evaluate&the&skeleton&deviation&from&gnathic&or&
menton&displacement&in&relation&to&the&vertical&
midline&of&the&face.& It&is&because&the&jaw&is&the&
mandibular&growth10,13,15.
&
DICOM&(Digital&Imaging&and&Communication&in&
measurements&with&the&VistaDent&3D&2.1&(GAC&
Dentsply,&New&York,&USA).&The&software&is&able&
volume&(mm3),& and&the&surface&(mm2)&through&
increase&the&conKidence&in&diagnosis&16.
&
images,&and&posteriorly&provide&exact&values&of&
the&studied&structures.&
&
sagittal&skeletal&growth&pattern&Class&I.&
70&years&old,&with&random&choice®arding&to&
MATERIALS.AND.METHODS
The&reference&points&and&plans&used&for&
JRD&X&Journal&of&Research&in&Dentistry,&Tubaro,&v.&2,&n.&2,&mar/apr.&2014
192
bigger&concavity& of&anterior&maxillary&portion;&
deviation&from&2&to&5mm&were&considered&with&
deviation&in&relation&to&the&medial&sagittal&plan&
works&2,3,9&(Figure&1).
Figure& 1.& Measures& evaluated& by& selection& of& individuals& and& for&
posterior&analysis&of&mandibular&asymmetries&in&patients.
&
a n t e r o p o s t e r i o r& m a x i l l o X m a n d i b u l a r&
CBCT&images&were&randomly&selected&and&once&
relationship&of&jaws)&between&0o&and&5o.
again&measured&by&the&same&author&(BFG)&with&
&
To&evaluate&the&mandibular&asymmetry,&
formula:&&D2/2N.
&
positive&value&is&attributed&to&it,& and&when&this&
tests&using&the&software&SPSS&20&for&Windows.
JRD&X&Journal&of&Research&in&Dentistry,&Tubaro,&v.&2,&n.&2,&mar/apr.&2014
193
(63.2%)&were&female.&
asymmetry&and&the&intensity&of&this&asymmetry&
&
signiKicance&adopted&was&5%&(p<0.05).
of&mandibular&asymmetry.&
RESULTS
!
of&ANB&angle&was&2.80,&the&total&of&individuals&
Frame&1.&Distribution&of&side&deviation&occurrence&of&mandibular&asymmetry&according&with&the&gender.
Right
N&(%)
Gender
&&&&&Male
&&&&&Female
&&&&&&Side.deviation&of&mandibular&asymmetry
Left
N&(%)
40a&(43,5%)
66a&(41,8%)
52a&(56,5%)
92a&(58,2%)
Each& subscribed& letter& means& a& subset& of& categories& of& side& deviation& in& which& the& proportion& of& columns& &does& not& show& signiKicant& differences&
among&them&according&with&the&level&of&signiKicance&5%&(p<0.05).
X2#=#0,069&a;#p#=#0,792#non.signi2icant#.#n#=#number#of#individuals;#%percentage
Frame&2&X&Distribution&of&intensity&occurrence&of&mandibular&asymmetry&according&with&the&gender.
Gender
&&&&&Male
&&&&&Female
&&&&&&&&&&&&&&&&&&&&&&Intensity&&of&mandibular&asymmetry&&
Slight&&N&(%)
Moderate&N&(%)
Severe&N&(%)
56a&&(60,9%)
85a&&(53,8%)
05a&&(5,4%)
19a&&(12,0%)
31a&&(33,7%)
54a&&(34,2%)
Each& subscribed& letter& means& a& subset& of& categories& of& side& deviation& in& which& the& proportion& of& columns& &does& not& show& signiKicant& differences&
among&them&according&with&the&level&of&signiKicance&5%&(p<0.05).
X2&=&3,150&a;&p&=&0,207&nonXsigniKicant&X&n&=&number&of&individuals;&%percentage
&
both&genders&(male&56.5%&and&female&58.2%),&
between&them&(p=0.792).&
&
slight,&moderate&and&severe&asymmetries&in&the&
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194
(34%)&and&24&(9.6%).
&
studies&3,21,23X27.
inKluence&in&the&facial&look&17X19.
&
&
balanced.&On&the&opposite,&the&term&asymmetry&
menton&is&identiKied&as&the& main&characteristic&
among&the&structures&10,18.
&
&
method&of&diagnosis&and&indicated&for&this& aim&
the&patient&or&people&who&live&with&him/her.&It&
20.
It&was&observed&that&most&of&the&sample&
(57.6%)&presented&gnathic&deviation&to&the&left,&
unbalance,&but&it&can&be&masked&by&soft&tissues&
which&recover&it.&Moderate&asymmetry&may&be&
observation&of&statistically&difference.&
&
surgical&and&orthodontic&procedures10.
&
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195
&
CONCLUSION
what&present&gnathic&deviation&from&2&to&5mm,&
present&preference&according&to&the&gender.&
studies&2,3,28.
&
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SJ.& ThreeXdimensional& soft& tissue& analysis& for& the&
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